Category Archives: Food Safety

Nov 7 2013
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Public Health News Roundup: November 7

FDA Takes Another Step to Reduce Consumption of Trans Fats
The U.S. Food and Drug Administration has taken another step to reduce American’s consumption of trans fats with a preliminary determination that partially hydrogenated oils (PHOs) are not “generally recognized as safe” for use in food. PHOs are the primary dietary source of artificial trans fat in processed foods. Up next is a 60-day comment period to collect more information and input on exactly what it would take for food manufacturers to reformulate products so that they do not include PHOs. “While consumption of potentially harmful artificial trans fat has declined over the last two decades in the United States, current intake remains a significant public health concern,” said FDA Commissioner Margaret A. Hamburg, M.D. “The FDA’s action today is an important step toward protecting more Americans from the potential dangers of trans fat. Further reduction in the amount of trans fat in the American diet could prevent an additional 20,000 heart attacks and 7,000 deaths from heart disease each year—a critical step in the protection of Americans’ health.” Read more on food safety.

Lack of Light Disrupts Sleep Cycles During Hospital Stays, Increases Patient Discomfort
Hospital stays may be even more uncomfortable for most patients than necessary because of an overall lack of adequate light, according to a new study in the Journal of Advanced Nursing. The small study found that lower levels of daytime light exposure were connected to worse mood, as well as more fatigue and pain, in patients. The poor light interfered with their bodies’ ability to adopt a normal sleep-wake cycle. Researchers found the lowest levels of daytime light exposure were tied to worse mood and more fatigue and pain among patients, compared to those whose rooms were better-lit during the day. "Until now, no one has looked at the associations among light and outcomes such as sleep, mood and pain experienced in the hospital," said Esther Bernhofer, lead author of the study and a nurse researcher at the Cleveland Clinic's Nursing Institute. "This study forms a basis for testing future lighting interventions to improve sleep-wake patterns, mood and pain in hospitalized adults.” Read more on mental health.

Study: No Link Between IVF, Increased Risk of Cancer in Kids
Despite years of concerns, a new study on in vitro fertilization (IVF) found no link between the conception technique and an increased risk of cancer in children. The findings were published in the New England Journal of Medicine. Researchers analyzed data on more than 106,000 children born through assisted reproduction between 1992 and 2008, finding the risk of them developing cancer was "the same as naturally conceived children," according to lead researcher Alastair Sutcliffe, MD, a specialist in general pediatrics at the University College London. More than 5 million children have been born through IVF since the first successful birth in 1978. "This study is extremely reassuring and should relieve anybody's anxiety about IVF," concluded Lawrence Grunfeld, MD, an associate clinical professor of obstetrics, gynecology and reproductive science at the Mount Sinai Icahn School of Medicine, in New York City. Read more on cancer.

Oct 31 2013
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Public Health News Roundup: October 31

New York City Council Votes to Raise Tobacco-purchasing Age to 21
With studies repeatedly showing that the earlier someone begins smoking, the more likely they are to become addicted, the New York City Council has voted to raise the age minimum required to buy tobacco products from to 21 years, up from 18 years. The bill passed 35-11. Mayor Michael R. Bloomberg has already announced he will sign the bill. The law would apply to all tobacco products, including cigarettes, electronic cigarettes, cigars and cigarillos. “This is literally legislation that will save lives,” said Christine C. Quinn, the Council speaker, according to The New York Times. The Council also voted to increase the penalties for retailers who evade tobacco taxes; for a prohibition on discounts for tobacco products; and for a minimum price of $10.50 a pack for cigarettes and little cigars. Read more on tobacco.

Analysis: Sports-related Youth Concussion Diagnoses Climbing
The growing number of diagnosed concussions in young athletes and their reluctance to admit when they have suffered a head injury—despite ever-growing awareness of the dangers of concussions—demonstrates the need for sports leagues and government agencies to become more active in preventing traumatic brain injuries, according to a new report from the Institute of Medicine and the National Research Council. In 2009, about 250,000 youth ages 5-21 were treated for sports-related concussions and other brain injuries in U.S. hospitals, up from approximately 150,000 in 2001. The analysis pointed to Hannah Steenhuysen, a high school soccer goalie in Rehoboth, Massachusetts, as an example of why relying on youth to report their head injuries on their own is not always an effective strategy. "You don't tell anyone usually when you get a headache because you don't want to be out of the game," she said. "I couldn't watch TV or text or even read—it was really tough. When I tried to go back to school, I couldn't keep up and everything got jumbled in my head." Read more on injury prevention.

Tips for Kids with Food Allergies on Halloween
Trick-or-treating and Halloween parties can be difficult for kids with food allergies. However, there are steps both kids and parents can take to make sure kids with food allergies still have a full night of fun, according to Joyce Rabbat, MD, a pediatric allergy specialist with the Loyola University Health System, in Chicago. "The key is education,” she said. “Make sure your child knows what he or she can eat. When in doubt, throw it out." Among her tips:

  • Plan parties and events that do not include food, candy or other edible treats.
  • Inform the host of any Halloween party if your child has a food allergy. You can also provide a list of foods that may trigger an allergic reaction.
  • Clean all cooking utensils, pans or other dishes if they have been in contact with a food allergen. Also make sure to wipe down surfaces.
  • Read labels to find out whether foods contain allergens or have been made on the same machine as other products that contain an allergen.
  • Carry self-injectable epinephrine.

Read more on food safety.

Oct 28 2013
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Public Health News Roundup: October 28

Pediatricians: Parent’s Religion Should Not Stand in the Way of Child’s Medical Care
While noting that parents have the right to determine a child’s medical care, a parent’s religious beliefs should not stand in the way of necessary medical care when the child is at risk for serious disability or death, according to a new policy statement from the American Academy of Pediatrics Committee on Bioethics. The organization is also calling for a repeal of all state exemptions to child abuse and neglect laws, as well as an end to funding for any religious or spiritual healing. "I think it's important that all children get appropriate medical care, that state policies should be clear about the obligations to provide this care and that state monies directed toward medical care should be used for established and effective therapies," said Armand Antommaria, MD, directors of the Ethics Center at Cincinnati Children's Hospital Medical Center in Ohio and one of the statement’s lead authors. Many religious groups currently decline mainstream and proven medical treatments. For example, Christian Scientists advocate prayer over medical treatment, and Jehovah’s Witnesses opposed blood transfusions. Read more on pediatrics

Study: Low-cost Football Gear as Effective as High-tech, High-cost Equipment at Preventing Head Injuries
A group of experts has performed an extensive study to determine which football helmets and mouth guards are best at preventing youth concussions: none of them. The researchers compared high-tech and custom equipment to low-cost, off-the-shelf equipment, finding no difference in the number of concussions for 1,300 players at 36 high schools during the 2012 football season. There are approximately 40,000 sports-related concussions in U.S. high schools every year. "We're certainly not saying that helmets and mouth guards aren't important. They do what they are supposed to do. Mouth guards prevent dental injuries, and helmets prevent skull fractures and scalp and face lacerations," said Margaret Alison Brooks, MD, the study's lead co-investigator. "But I don't think the manufacturing companies have the data to support [the claim that] if a parent buys a specific model, their child will have a reduced risk of concussion." The findings will be presented today at an American Academy of Pediatrics meeting in Orlando, Fla. Read more on injury prevention.

FDA: Recall of Certain Kraft and Polly-O String Cheese Products
Kraft Foods Group has announced a voluntary recall of some varieties of Kraft and Polly-O String Cheese and String Cheese Twists products because they might spoil before their “Best When Use By” code dates. Approximately 735,000 cases of the product will be affected throughout the United States, each with code dates between October 25, 2013 and February 11, 2014. Kraft announced the recall after receiving several reports of premature spoilage and ceasing the production and distribution of the questionable products. For full refunds, customers can return the products to the store where they were purchased or call Kraft Foods Consumer Relations at 1-800-816-9432 between 9 am and 6 pm (Eastern). Read more on food safety.

Oct 14 2013
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Public Health News Roundup: October 14

Study: Erratic Bedtimes Linked to Kids’ Behavior Problems
Children with erratic bedtimes also exhibit more behavior problems at home and at school, according to a new study in the journal Pediatrics. Researchers analyzed date on more than 10,000 children who were part of long-term sleep studies, finding that kids without a regular bedtime scored worse on a measure of behavior problems including acting unhappy, getting into fights and being inconsiderate. "If you are constantly changing the amounts of sleep you get or the different times you go to bed, it's likely to mess up your body clock," said study leader Yvonne Kelly, from University College London. "That has all sorts of impacts on how your body is able to work the following day," Kelly, from University College London.” However, the researchers also found that when a child went from no set bedtime to a scheduled bedtime, their behavior improved. Read more on pediatrics.

Overweight Teens at Increased Risk of Later Esophageal Cancer
People who are overweight or obese as teens have nearly twice the risk of developing esophageal cancer later in life when compared to their peers with healthy weights, according to a new study in the journal Cancer. The study also found that social status, economic status and education levels can all be factors in the development of gastric cancers; poor teens are at twice the risk of developing stomach cancer, as are teens with nine years of fewer of education. The study included more than 1 million male Israeli teens. "We look at obesity as dangerous from cardiovascular aspects at ages 40 and over, but here we can see that it has effects much earlier," said study author Zohar Levi, MD, of the Rabin Medical Center in Israel. However, the study did not prove cause-and-effect, so further research is needed to determine whether losing weight or gaining higher social or economic status later in life can reduce the risks. Read more on cancer.

USDA: California Plants Linked to Salmonella Can Stay Open
After making “immediate substantive changes to their slaughter and processing,” three California poultry processing plants tied to a salmonella outbreak in 17 states will remain open, the U.S. Department of Agriculture (USDA) has determined. The plants will implement new food safety controls and the USDA will monitor the plants products for the next three months. The outbreak has sickened 278 people since May; the normal hospitalization rate is about 20 percent, but antibiotic resistance means about 42 percent of the people sickened in this outbreak were hospitalized. Read more on food safety.

Oct 8 2013
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Public Health News Roundup: October 8

AHA: Health Care Providers Should Emphasize Healthy Behaviors in Cardio Care
When it comes to treating cardiovascular health, health care providers should place just as much emphasis on correcting healthy behaviors as they do addressing the physical indicators of the risk for heart disease, according to a new statement from the American Heart Association (AHA). “We’re talking about a paradigm shift from only treating biomarkers — physical indicators of a person’s risk for heart disease — to helping people change unhealthy behaviors, such as smoking, unhealthy body weight, poor diet quality and lack of physical activity,” said lead author Bonnie Spring, PhD, a professor of preventive medicine and psychiatry and behavioral sciences at Northwestern University in Chicago. “We already treat physical risk factors that can be measured through a blood sample or a blood pressure reading in a doctor’s office, yet people put their health at risk through their behaviors. We can’t measure the results of these behaviors in their bodies yet.”

The AHA’s recommended “five A’s” to patient treatment:

  • Assess a patient’s risk behaviors for heart disease.
  • Advise change, such as weight loss or exercise.
  • Agree on an action plan.
  • Assist with treatment.
  • Arrange for follow-up care.

AHA’s goals for 2020 include improving the cardiovascular health of all Americans by 20 percent, while also reducing deaths from cardiovascular diseases and stroke by 20 percent. Read more on heart health.

Study: 1 in 10 Youth Admit to Sexual Violence
Approximately one in 10 teenagers and young adults admit to sexual violence, according to a new study in the journal JAMA Pediatrics. Researchers said violent pornography may be partially to blame for the acts, which included coercive sex, sexual assault and rape, and most often with a romantic partner. What’s more, about two in three said the act was never discovered, so there was never a punishment. "We know a bit about youth who are victims of sexual violence, but we don't know much at all about youth as perpetrators," said study co-author Michele Ybarra, president and research director of the Center for Innovative Public Health Research in San Clemente, Calif. "It's important we know more if we're going to reduce the sexual-violence rate." Ybarra said sexual-violence-prevention programs should emphasize the understanding of explicit consent and the tactics of coercive sex. "They may say, 'Unless you have sex with me, I'm going to go have sex with someone else,’” said Angela Diaz, MD, MPH, director of Mount Sinai Hospital's Adolescent Health Center. "Young people have to learn that if their partner says that, maybe they're better off if they do go somewhere else." Programs should also focus on the role of the bystander and the importance of reporting incidents. Read more on violence.

Salmonella Outbreak Sickens 278 People in 18 States
Approximately 278 people in 18 states have become sick from a salmonella outbreak linked to raw chicken products, according to the U.S. Department of Agriculture. The products were produced at three California plants owned by Foster Farms and distributed mostly to retailers in California, Oregon and Washington state. Local, state and federal health officials made the connection. While the outbreak is “ongoing,” there is currently no recall as the U.S. Centers for Disease Control and Prevention is working with state health departments to monitor the matter while the Food Safety and Inspection Service investigated the outbreak. Read more on food safety.

Sep 19 2013
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Public Health News Roundup: September 19

Confusing ‘Sell-by’ and ‘Best-before’ Labeling Leads to Billions of Pounds of Wasted Food
Inconsistent “sell-by” and “best-before” dates on package labels lead Americans to needlessly discard billions of pounds of food every year, according to a new study by Harvard Law School and the Natural Resources Defense Council. The labels are meant to inform retailers about a food product’s peak freshness. "The labeling system is aimed at helping consumers understand freshness, but it fails—they think it's about safety. And (consumers) are wasting money and wasting food because of this misunderstanding," said co-author Emily Broad Lieb, who led the report from the Harvard Law School's Food Law and Policy Clinic. The study recommends that “sell-by” dates be reconfigured so as to be invisible to consumers, that a uniform label system is created and that technology-based “smart labels” be used more often. "Under the current patchwork of state and federal laws, consumers are left in the lurch, forced to decipher the differences between 'sell-by' and 'best if used by,' and too often food is either thrown out prematurely, or families wind up consuming dangerous or spoiled food," said Congresswoman Nita Lowey (D-NY), in a release. Read more on food safety.

Study: Hospitals that Perform the Most Surgeries Also Have Lowest Readmission Rates
A new study from the New England Journal of Medicine indicates that the higher quality of care during a surgical procedure, the lower the likelihood of the patient being readmitted for additional surgery. It also found that hospitals that performed the most procedures also, on average, delivered a higher quality of care. In a review of about 480,000 patients discharged from more than 3,000 U.S. hospitals, the researchers found that one in seven were readmitted within 30 days, with the hospitals that did the most procedures having both the lowest readmission rates and the lowest death rates. Hospitals with the most surgeries had readmission rates of about 12.7 percent, compared to 16.8 percent for hospitals with the fewest procedures. "If hospitals performing very few surgeries do not have the volume required to create highly reliable care systems despite their best quality-improvement efforts, perhaps they should not be performing them," said Don Goldmann, MD, chief medical and scientific officer of the Institute for Healthcare Improvement in Boston, who was not involved in the study. "This is a provocative suggestion and deserves careful consideration before being implemented." Read more on access to health care.

HHS ‘Meaningful Consent’ Website to Help Providers, Patients Understands EHR Sharing
As electronic health records (EHRs) become more common, a new website from the U.S. Department of Health and Human Services (HHS) will help health care providers and patients determine exactly how they want their electronic patient health information shared. Meaningful Consent will address issues such as the laws and policies related to the health information exchange (HIE). It also includes strategies and tools for providers, certain health information organizations and other implementers of health information technology. The site also provides background, lessons learned, videos and customizable tools from the HHS Office of the National Coordinator for Health Information Technology’s eConsent pilot project, which tested the use of tablet computers to provide patients with better information on EHRs. Read more on technology.

Aug 7 2013
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Public Health News Roundup: August 7

Conflicts of Interest in Determination of Food Additive Safety
Who determines whether a food additive is safe? Often it’s people with ties to the food additive industry, according to a new conflict-of-interest study from The Pew Charitable Trusts in the journal JAMA Internal Medicine. From 1997 to 2012, about 20 percent of safety determinations submitted to the U.S. Food and Drug Administration were authored by employees of food additive manufacturers, and 13 percent were authored by someone working a consultant selected by the manufacturer. Researchers also found that the expert panels tasked with conducting most of the safety assessments rely on many of the same experts over and over again. "There's a cadre of 10 people that serve on almost all of these expert panels," said study author Thomas Neltner, director of Pew's food additives project. "Three-quarters of the panels contained at least one of these people. One person served on 44 percent of the panels, which tells us there's not only conflicts of interest, but there's a very small group of people making these decisions." Michael Jacobson, executive director of the Center for Science in the Public Interest, sees these results as a clear problem that needs to be addressed. "These committees give a very superficial, one-sided review," he said. "They want to please the sponsor, and then maybe they will get more business because they've proven themselves trustworthy, but it's no way to run a food safety review process." Read more on food safety.

CDC: 1 in 8 Preschoolers Obese, Raising their Risk for Adult Obesity
About one in eight—or 12 percent—of preschoolers are obese. However, after decades spent watching that number climb, nineteen states and territories are seeing drops in obesity among low-income preschoolers, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). Overweight and obese children are five times more likely to grow up to be obese adults, so early intervention by state and local health officials is critical. The report provides a number of ways they can help, including the creation of partnerships with community members to make community changes that promote healthy eating and active living, as well as making it easier for families with children to buy healthy, affordable foods and beverages in their neighborhoods. Read more on obesity.

Hospitals’ Exchange of Electronic Health Records Climbed 41 Percent from 2008 to 2012
Health information exchange (HIE) between hospitals and providers outside their organizations climbed 41 percent from 2008 to 2012, with six in 10 hospitals exchanging electronic health records (EHR) in 2012, according to a new study in the journal Health Affairs. The researchers say this illustrates how EHRs have become complementary tools that improve health care quality and safety. “We know that the exchange of health information is integral to the ongoing efforts to transform the nation’s health care system and we will continue to see that grow as more hospitals and other providers adopt and use health IT to improve patient health and care,” said Farzad Mostashari, MD, the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. “Our new research is crystal clear: health information exchange is happening and it is growing. But we still have a long road ahead toward universal interoperability.” Read more on technology.

Aug 2 2013
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Public Health News Roundup: August 2

Nine-state Study Shows Statewide Smoking Bans Would Not Hurt Restaurant, Bar Business
Despite the concerns of many proprietors, statewide smoke-free laws would not hurt business at restaurants and bars, according to a new study in the journal Preventing Chronic Disease. Bans on workplace and public area smoking reduce exposure to secondhand smoke, encourage smokers to quit, improve the health employees and reduce the risk for heart attack hospitalizations. The findings of the CDC Foundation study—the largest such analysis, with nine states—line up with previous research. The participating states were chosen because they do not have statewide smoking bans, but do have a good deal of local laws. “Smoke-free laws make good business sense—they improve health, save lives, increase productivity, and reduce health care costs,” said U.S. Centers for Disease and Control Prevention Director Tom Frieden, MD, MPH. Communities throughout the United States have made great strides in protecting workers and the public from secondhand smoke in the past decade, but too many Americans continue to be exposed to secondhand smoke on the job and in public places.”

Below is a related smoke-free video for the state of Texas. Watch all the videos here.

Read more on tobacco.

FDA Sets New Standards for ‘Gluten-free’ Food Labeling
The U.S. Food and Drug Administration (FDA) has set a new standard to define “gluten-free” for voluntary food labeling. People with the autoimmune digestive condition of celiac disease—about 3 million Americans—can manage the condition by eating a diet free of gluten, which is found in naturally in wheat, rye, barley and cross-bred hybrids of these grains. Under the new rules, “gluten-free” labeling is restricted to products that meet all of the FDA requirements, including that the food contains less than 20 parts per million of gluten. The standards also apply to products that claim “no gluten,” “free of gluten” and “without gluten.” FDA is giving food manufacturers one year to come in line with the new standard. “Adherence to a gluten-free diet is the key to treating celiac disease, which can be very disruptive to everyday life,” said FDA Commissioner Margaret A. Hamburg, MD. “The FDA’s new ‘gluten-free’ definition will help people with this condition make food choices with confidence and allow them to better manage their health.” Read more on food safety.

CDC: Murders from Guns Down, But Suicide Rate is Up
The latest Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC) has both good and bad news on gun violence—and both stress the need for further measures to reduce gun violence, especially early prevention. According to the CDC, gun-murder rate is down, but the suicide rate is up. The murder rate dropped around 15 percent from 2006-07 to 2009-10 in the majority of the fifty largest U.S. cities, but the suicide rate climbed as much as 15 percent in about 75 percent of the cities. In 2009-10 there were approximately 22,500 murders and 38,000 suicides involving a gun. "If there is any question that gun control is a big problem, here's a good example of why," said Victor Fornari, MD, chief of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y. "Access to firearms is a serious public health problem. Limiting access to firearms would reduce homicide as well as suicide. As long as guns are available there are going to be these violent outcomes." Read more on violence.

Jul 31 2013
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Public Health News Roundup: July 31

Tainted Salad Mix Linked to Parasite Outbreak in Two States; 13 Other States Still Looking for Answers
State and federal health officials have narrowed in on a prepackaged salad mix as the possible source of a cyclospora outbreak that has sickened 370 people in 15 states. Both Nebraska and Iowa officials have identified the salad as the source; a total of 221 people in those states have fallen ill so far from the stomach-sickening parasite. The U.S. Food and Drug Administration (FDA) is still working to identify the cause in the 13 other states. “FDA will continue to work with its federal, state and local partners in the investigation to determine whether this conclusion applies to the increased number of cases of cyclosporiasis in other states,” the FDA said in a statement. ”Should a specific food item be identified, the FDA, the U.S. Centers for Disease Control and Prevention, state and local partners will work to track it to its source, determine why the outbreak occurred, and if contamination is still a risk, implement preventive action, which will help to keep an outbreak like this from happening again.” Read more on food safety.

New Model Shows Kids Consuming Far More Calories than Previously Realized
It takes far more calories for kids to gain weight than was previously realized, according to a new study in The Lancet Diabetes & Endocrinology. And, given the high rate of childhood obesity, this means kids are consuming far more calories than either their parents or health care providers realize. The new caloric model takes into account the energy requirements for boys and girls; the fact that kids generally have higher metabolisms than adults; the average drop in physical activity as kids age; and the energy required to maintain a bigger body size as they age. Whereas the old model said a normal-weight girl at age 5 would need to consume about 40 extra calories a day to be 22 pounds overweight by age 10, the new model shows its actually 400 extra calories. "Importantly, given the rather large calorie excesses fueling childhood obesity, this model is a rebuttal to the food industry arguments that exercise alone can be the answer," said David Katz, MD, director of the Yale Prevention Research Center and editor of the journal Childhood Obesity, who was not involved in the study. "For our kids to achieve healthy weight, control of calories in, not just calories out, will have to be part of the formula." Read more on obesity.

Sequester to Close all HUD Offices on Friday, August 2
Every office of the U.S. Department of Housing and Urban Development (HUD) will be closed on Friday, August 2 as part of the sequester which is being felt across all of government. The automatic spending cuts took effect March 1. HUD’s plan is to pair its seven required furlough days with holidays and weekends. HUD is encouraging people and businesses that work with the agency to plan around the schedule day of shutdown. Read more on budgets.

Jul 30 2013
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Operation Chuckwagon: Food Safety for Food Trucks

The Public Health Quality Improvement Exchange (PHQIX) is an online communication hub for public health professionals interested in learning and sharing information about quality improvement in public health. Created by RTI International and funded by The Robert Wood Johnson Foundation, PHQIX launched in September of 2012 with the goal of sustaining national efforts at quality improvement by providing public health practitioners with the opportunity to learn from the experiences of their colleagues. PHQIX includes:

  • An online database of quality improvement efforts by public health departments across the country
  • Search and query functions to help users find relevant examples for their own work
  • A forum for dialogue on quality improvement

A recent initiative shared on the site called Operation Chuckwagon looked at the maintaining quality control of food safety for mobile food trucks in Northern Kentucky.

Food trucks are growing in popularity across the country as an inexpensive way to try different cuisines, and following some of the weather disasters this past year, some municipalities dispatched food trucks, with cost covered for residents, to areas without power and in need of food. Safety is critical. A recent report in the Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention found an outbreak of 91 salmonella cases linked to lunch trucks in Alberta, Canada. An investigation by food inspectors found many food storage and handling violations.

The Kentucky project increased the percentage of properly licensed mobile food vendors to 100 percent from a baseline of 25 percent, and also achieved a 100 percent compliance rate with required temperature controls, which had been a big problem during initial inspections.

NewPublicHealth recently spoke with Ted Talley, environmental health manager at the health department, about the quality improvement initiative.

NewPublicHealth: What’s novel about how you’ve approached the food trucks and made it easier for them to have food safety inspections?

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